Sunday, June 5, 2016

Lois Noland reflects on service as Macon County Public Administrator

Some say it is the hardest job in all of Macon County.

Elected in 2004, Lois Noland is in her twelfth year as Macon County’s Public Administrator. Charged with taking care of individuals in the county that are not able to make decisions for themselves, Noland sees the task as a ministry more than a job.  “I filed for this position after much prayer and consideration, and there have been many situations that I’ve just had to turn over to God.”

Growing up in extreme Northwest Missouri, Noland’s had experience with many dysfunctional families, including poverty, mental illness and developmental disabilities to help prepare her for the job.  “The more I work with families the more I understand we all have members who are stronger and weaker, but everyone I’ve met has a strength that can be built upon.”

Former Public Administrator Dick Jones recruited Noland for the position while she served as the activities director of Macon Health Care. At that job, Noland learned the challenges of working with the elderly.

“I worried about my heart, that I’d fall in love with those people and lose bits of it, and I did…In my first week, a resident had a heart attack in the dining room.  We all rushed in and he died with his head in my lap. I learned so much about life and death, dementia, depression, mental illness, diabetes and elderly issues that I assist my clients with still today,” said Noland. “But it is still very challenging dealing with the emotional attachment to my clients.”

The job takes more than just a big heart.

Public Administrators serve in the capacity of a guardian taking the responsibility of the decisions regarding the person, a conservator taking the responsibility of the decisions regarding the finances or a personal representative taking responsibility regarding an estate.

Noland is charged with tending to a current case load of 76 individuals. “Each year, I provide a report to the court, accounting for every dollar and cent for the transactions for every person under my care,” explained Noland.

Public Administrators are charged with handling paperwork for Medicaid, Medicare, disability, insurance policies,  pre-paid burials, the Veterans Administration… the list goes on and on.  Some estates we deal with are owned by millionaires,” explained Noland. “The paperwork and accounting responsibilities are significant.”

“I also oversee my assistant’s work and handle the monthly financial obligations and life decisions of dozens of clients with very complicated lives,” added Noland. “I speak with doctors, lawyers, judges and occasionally call and complain to those in the state capitol!”

Prior to filing for office, public administrator candidates in Missouri must be bonded, protecting taxpayers from potential fraud and abuse by officeholders. Public administrators have access to all financial information of their clients. Often, candidates with personal credit issues have trouble getting bonded.

Public administrators deal with a variety of individuals with a variety of disabilities.

Noland says her caseload is filled with individuals who have been deemed incapacitated or disabled. The diagnoses includes borderline personality disorder, bipolar, paranoid schizophrenia, MRDD, heart disease, stroke and cancer.

Noland’s background in childcare for 19 years also helped prepared her for the job. “I always taught kids and their parents about expected behavior. When behavior is not appropriate there are consequences. The same is true for my clients.  When serving as their guardian/conservator there is accountability,” said Noland.

“Today I’m teaching clients that their negative behavior will have consequences and that it’s not always caused by their mental illness - sometimes it’s a choice.  By that same standard, I’m teaching positive actions lead to a less restrictive environment such as independent living,” added Noland.

“Medication and dietary compliance are two very important issues that have consequences and oversight is sometimes necessary for the health of the client.”

A job that comes with many risks and difficult decisions.

The dangers of the job of public administrators are growing, as the average age of clients becomes younger due to substance abuse and other societal problems. “Working with clients dealing with PTSD or certain drug addictions adds a certain level of difficulty to the job,” added Noland.

“Finding placement is an extra challenge that’s increasing every year.  For clients with difficult diagnoses such as PICA, it is extremely difficult.  There are no facilities in this area so you’re seeking placement in St. Louis or Kansas City and those beds are hard to come by.”

Other tough issues facing public administrators include end-of life-decisions, guardianship of minors and lack of funding and health benefits to pay for care.

The next Macon County Public Administrator will be chosen in August.

The election to replace Noland as Public Administrator will be decided in the August primary as no Democrats and four Republicans filed for the position. Candidates include Johnny Contratto, John Czuba, Craig Fuller and Joe Thomas.

Noland encourages voters to carefully review candidates’ experiences that fit the task: “Anyone you know can come under the care of the public administrator,” said Noland.  

During Noland’s years of service, she has served many of the county’s poorest residents, but has also served as the guardian of a retired MU Professor, an electrical engineer, a retired medical doctor and retired teachers. “Sometimes there is no family to serve as the guardian/conservator and then sometimes there is a wonderful family but for one reason or the other they are not the best choice to make the tough decisions that need to be made,” explained Noland.

“We should look for candidates that have not only a big heart, but also the maturity and experience to deal with the paperwork and integrity to protect the clients and the office.”

Noland added that she looks forward to working with the next public administrator to ensure the clients she has befriended over the years have their needs met.

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